Uncovering electrophysiological and vascular signatures of implicit emotional prosody

The capability of differentiating between various emotional states in speech displays a crucial prerequisite for successful social interactions. The aim of the present study was to investigate neural processes underlying this differentiating ability by applying a simultaneous neuroscientific approach in order to gain both electrophysiological (via electroencephalography, EEG) and vascular (via functional near-infrared-spectroscopy, fNIRS) responses. Pseudowords conforming to angry, happy, and neutral prosody were presented acoustically to participants using a passive listening paradigm in order to capture implicit mechanisms of emotional prosody processing. Event-related brain potentials (ERPs) revealed a larger P200 and an increased late positive potential (LPP) for happy prosody as well as larger negativities for angry and neutral prosody compared to happy prosody around 500 ms. FNIRS results showed increased activations for angry prosody at right fronto-temporal areas. Correlation between negativity in the EEG and activation in fNIRS for angry prosody suggests analogous underlying processes resembling a negativity bias. Overall, results indicate that mechanisms of emotional and phonological encoding (P200), emotional evaluation (increased negativities) as well as emotional arousal and relevance (LPP) are present during implicit processing of emotional prosody.

Cognitive Enhancement via Network-Targeted Cortico-cortical Associative Brain Stimulation

Fluid intelligence (gf) represents a crucial component of human cognition, as it correlates with academic achievement, successful aging, and longevity. However, it has strong resilience against enhancement interventions, making the identification of gf enhancement approaches a key unmet goal of cognitive neuroscience. Here, we applied a spike-timing-dependent plasticity (STDP)-inducing brain stimulation protocol, named cortico-cortical paired associative stimulation (cc-PAS), to modulate gf in 29 healthy young subjects (13 females-mean ± standard deviation, 25.43 years ± 3.69), based on dual-coil transcranial magnetic stimulation (TMS). Pairs of neuronavigated TMS pulses (10-ms interval) were delivered over two frontoparietal nodes of the gf network, based on individual functional magnetic resonance imaging data and in accordance with cognitive models of information processing across the prefrontal and parietal lobe. cc-PAS enhanced accuracy at gf tasks, with parieto-frontal and fronto-parietal stimulation significantly increasing logical and relational reasoning, respectively. Results suggest the possibility of using SPTD-inducing TMS protocols to causally validate cognitive models by selectively engaging relevant networks and manipulating inter-regional temporal dynamics supporting specific cognitive functions.

The Brain Differentially Prepares Inner and Overt Speech Production: Electrophysiological and Vascular Evidence

Speech production not only relies on spoken (overt speech) but also on silent output (inner speech). Little is known about whether inner and overt speech are processed differently and which neural mechanisms are involved. By simultaneously applying electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), we tried to disentangle executive control from motor and linguistic processes. A preparation phase was introduced additionally to the examination of overt and inner speech directly during naming (i.e., speech execution). Participants completed a picture-naming paradigm in which the pure preparation phase of a subsequent speech production and the actual speech execution phase could be differentiated. fNIRS results revealed a larger activation for overt rather than inner speech at bilateral prefrontal to parietal regions during the preparation and at bilateral temporal regions during the execution phase. EEG results showed a larger negativity for inner compared to overt speech between 200 and 500 ms during the preparation phase and between 300 and 500 ms during the execution phase. Findings of the preparation phase indicated that differences between inner and overt speech are not exclusively driven by specific linguistic and motor processes but also impacted by inhibitory mechanisms. Results of the execution phase suggest that inhibitory processes operate during phonological code retrieval and encoding.

The use of radiation therapy for oligoprogressive/oligopersistent oncogene-driven non small cell lung cancer: State of the art

Oncogene-driven non small cell lung cancer (NSCLC) is a distinct entity in thoracic oncology. The availability of effective target therapies, like EGFR inhibitors or ALK inhibitors, have revolutionized the prognosis of these patients. However, despite an initial response in the majority of patients, drug resistance ultimately occurs. In some cases, this resistance develops in few clonal cells (oligoprogression), so that a local ablation of these resistant deposits could allow to maintain the same systemic therapy and possibly to prolong patients' survival. For these purposes, stereotactic body radiation therapy (SBRT) is an ideal local ablative treatment, because it is effective, non invasive and with limited side effects. In this review, we aim to analyze available clinical data to verify whether SBRT can allow these patients to continue with existing target therapy longer, delay the switch to other systemic therapies and improve their outcome modifying the natural history of the disease.

How the Brain Understands Spoken and Sung Sentences

The present study investigates whether meaning is similarly extracted from spoken and sung sentences. For this purpose, subjects listened to semantically correct and incorrect sentences while performing a correctness judgement task. In order to examine underlying neural mechanisms, a multi-methodological approach was chosen combining two neuroscientific methods with behavioral data. In particular, fast dynamic changes reflected in the semantically associated N400 component of the electroencephalography (EEG) were simultaneously assessed with the topographically more fine-grained vascular signals acquired by the functional near-infrared spectroscopy (fNIRS). EEG results revealed a larger N400 for incorrect compared to correct sentences in both spoken and sung sentences. However, the N400 was delayed for sung sentences, potentially due to the longer sentence duration. fNIRS results revealed larger activations for spoken compared to sung sentences irrespective of semantic correctness at predominantly left-hemispheric areas, potentially suggesting a greater familiarity with spoken material. Furthermore, the fNIRS revealed a widespread activation for correct compared to incorrect sentences irrespective of modality, potentially indicating a successful processing of sentence meaning. The combined results indicate similar semantic processing in speech and song.

Silva S, Netto AS. Castration age and growth, meat production and meat quality of Nellore male cattle

Castration in beef cattle production has been proposed to reduce sexual and aggressive behaviour, increase carcass fat deposition, and improve meat quality traits, such as tenderness and juiciness. The aim of the present study was to evaluate the effects of the age of castration on performance, subprimal yield and meat quality of Nellore cattle raised on a pasture system. A total of 24 Nellore males were raised in a grass-fed system with Brachiaria brizantha since birth until slaughter (at 30 months old). Three treatments were assigned: castration at weaning (CW); castration at 20 months old (C20); and intact bulls (NoC). Males were weighed, and muscle and fat thickness were periodically evaluated by ultrasonography. The cold carcass weight, dressing and carcass pH (pH 24), and subprimal cut weights were recorded after 24 h of chilling. Samples of Longissimus lumborum (LL) were taken to measure meat quality traits. Animals that were castrated at weaning had lower bodyweight after 10 months of age with no changes in the supplement intakes, average daily gain, hot carcass weight and cold carcass weight compared with NoC. Intact males had greater cooking losses and carcass yield compared with others, with no differences for LL pH 24 according to the treatments. The castration did not change the LL muscle area, but decreased total forequarter, chunk, shoulder and eye of round weights, and increased the back fat over LL and rump fat. Animals castrated at weaning had higher marbling compared with others. In addition, regardless of age, castration improved tenderness, increased LL total lipids and decreased moisture compared with NoC. For sensory property, steers castrated at 20 months of age had lower juiciness, and NoC had a greater global sensory property compared with steers castrated at 20 months old. In conclusion, steers castrated at weaning had lower growth rate, final bodyweight and meat production compared with intact males. However, when castration was performed at 20 months, animals did not differ in most cases from castration at weaning and NoC. Tenderness was improved by castration, but sensory traits did not differ between groups.

Infusion-related reactions during Natalizumab treatment: Do we still need a post-infusion observation period?

BACKGROUND

Natalizumab (NTZ) is a humanized monoclonal antibody used in the treatment of relapsing remitting multiple sclerosis. Although NTZ is usually well-tolerated, infusion-related reactions (IRRs) may occur, and the patients have to be monitored during the infusion and for one hour afterwards.

OBJECTIVE

To identify frequency and severity of IRRs during NTZ infusions and one-hour post-infusion observation period in a clinical practice setting.

METHODS

Multicenter, observational study involving three Swiss (Lugano, St. Gallen and Luzern) and two Italian (Milano and Napoli) tertiary MS centers. Predisposing factors to IRRs were investigated using multivariate Cox regression models.

RESULTS

A total of 11'133 infusions received by 302 MS patients were analyzed (68.9% females, median age 33.6 years, median EDSS 2.5). IRRs occurred in 24 (8%) patients during NTZ infusions and in 7 (2%) during one-hour post-infusion. Only 8 patients needed pharmacological treatment, of whom 7 during NTZ infusion. Age, sex and history of allergies were not associated with risks for IRR. The frequency of post infusion IRRs after the fifth cycle was low compared to that during the first four infusions (0.83% vs 0.06%).

CONCLUSION

In our cohort, NTZ associated IRR mainly occurred during the infusion period compared to the one-hour observational period. Also, the first IRR exclusively occurred within the first 4 NTZ administrations. However, further multi-center studies with a larger sample size are needed to capture rare and serious events that could emerge during the observational period and to make clinical recommendations.

Crowdfunding for unmet medical needs: the case of CAR-T and Gofundme

Background

Crowdfunding (CF) is the practice of financing a project by raising money from a large number of people. Many patients use online CF platforms to fund medical needs, whether unmet by their healthcare service - therefore to be sought elsewhere -, or when unable to afford them. CAR-T (Chimeric antigen receptor T-cells) is an innovative therapy approved to treat several types of lymphoma and with potential to treat many other cancers. CAR-T is available in most countries through clinical trials only and its diffusion is limited by high costs. Gofundme is a CF platform ’leader in online medical fundraising’. The objective of this study is to shed some light on the phenomenon of CF for CAR-T therapy, describing the campaigns started on Gofundme.

Methods

We extracted data from CAR-T campaigns started in Europe and publicly available on Gofundme until March 2019. Data related to each campaign has been analyzed and reported through descriptive analyses.

Results

Since 2017, 26 CAR-T treatment campaigns have been started. Due to the privacy policy of the platform, we were able to retrieve data from only 12 of them; 3 campaigns were closed, thus not disclosing enough data to be included. Nine campaigns were studied: 4 from Italy, 4 from the UK, 1 from Spain. The United States were the main destination. The median campaign goal was 180k€. The number of campaign shares on social media and the percentage of goal raised seemed to be linked.

Conclusions

CF is unquestionably a good expression of the Internet: it channels empathy towards important causes, providing tangible help. However, when applied to healthcare - especially to experimental treatments -, several questions arise. Patients affected by treatment resistant cancers may be prone trying new treatments to keep the hope alive, even when indication is missing or scientific evidence is lacking. Policymakers should monitor healthcare related CF campaigns, both for equity and safety reasons.

Key messages

Policymaker should monitor healthcare related CF campaigns, both for equity and safety reasons. Healthcare related crowdfunding campaigns could be interpreted as an indicator of unmet medical needs.

Pediatric vaccination appointment scheduling: experience from an Italian clinic

Issue/problem

Since 2012 pediatric vaccination coverages in Italy have been decreasing. Negative trends have been recorded especially for hexavalent and MMR vaccines. In mid-2017 the Italian government passed an act making ten vaccines compulsory. Most recent data show the act is working, however other aspects of the process should be improved.

Description of the problem

Parents are invited to bring their children to the clinic through letters or telephone calls. Vaccination appointments are scheduled during weekdays, either in the morning, the afternoon, or both. Each session is carried out by a physician and a nurse, with a new patient scheduled every ten minutes. Appointments and vaccinations are registered on the vaccine-specific electronic health record (SISPC).

Results

In March 2019, the vaccination clinic worked 21 days for a total of 29 sessions. 823 appointments were available, 797 of them (96.8%) had a patient scheduled before the session started. 547 (68.6%) attended the vaccination appointment, 98.4% of them were vaccinated (538, 67.5% of the total patients scheduled). Among those who did not attend the scheduled appointment, only 108 (43.2%) agreed to reschedule. Eventually, only 58.3% of these patients attended the rescheduled appointment. No statistically significant differences among those who attended and those who did not attend the appointment were found among the variables retrieved from SISPC: day, time, vaccination planned (type, and if mandatory or not), sex, age.

Lessons

A third of available vaccination appointments in our clinic were lost. Despite the ease through which patients can reschedule an appointment, many choose not to and left their appointments unattended. Although missing a vaccination appointment can be appropriate - e.g. when the child is sick - and great effort should be put to achieve the goal of improving coverages, policymakers should also consider provisions to discourage such behaviors for a better use of resources.

Key messages

A third of available vaccination appointments in our clinic were lost in a month. Keeping in mind the goal of improving coverages, policymakers should aim for the best possible use of resources.

The complex phenotype of spinocerebellar ataxia type 48 in eight unrelated Italian families

BACKGROUND AND PURPOSE

Heterozygous mutations in the STUB1 gene have recently been associated with an autosomal dominant form of spinocerebellar ataxia (SCA) associated with cerebellar cognitive-affective syndrome (CCAS), named SCA48.

METHODS

Molecular screening was performed in a cohort of 235 unrelated patients with adult-onset, autosomal dominant (17) or sporadic (218) cerebellar ataxia, negative for pathological trinucleotide expansions in the common SCAs, FRDA and FXTAS loci, by using targeted multigene panels or whole-exome sequencing. Bioinformatics analyses, detailed neurological phenotyping and family segregation studies corroborated the pathogenicity of the novel STUB1 mutations. Clinico-diagnostic findings were reviewed to define the phenotypic spectrum.

RESULTS

Eight heterozygous STUB1 mutations were identified, six of which were novel in 11 patients from eight index families, giving an estimated overall frequency of 3.4% (8/235) for SCA48 in our study cohort, rising to 23.5% (4/17) when considering only familial cases. All our SCA48 patients had cerebellar ataxia and dysarthria associated with cerebellar atrophy on brain magnetic resonance imaging; of note, many cases were also associated with parkinsonism, chorea and dystonia. CCAS also occurred frequently, whereas definite signs of pyramidal tract dysfunction and peripheral nervous system involvement were absent. One SCA48 patient presented with hypogonadism, associated with other autoimmune endocrine dysfunctions.

CONCLUSIONS

Our results support SCA48 as a significant cause of adult-onset SCA. Besides CCAS, our SCA48 patients often showed movement disorders and other clinical manifestations previously described in SCAR16, linked to biallelic variants in the same gene, thus suggesting a continuous clinical spectrum and significant overlap amongst recessive and dominantly inherited mutations in STUB1.

Reduction of intratumoral brain perfusion by noninvasive transcranial electrical stimulation

Malignant brain neoplasms have a poor prognosis despite aggressive treatments. Animal models and evidence from human bodily tumors reveal that sustained reduction in tumor perfusion via electrical stimulation promotes tumor necrosis, therefore possibly representing a therapeutic option for patients with brain tumors. Here, we demonstrate that transcranial electrical stimulation (tES) allows to safely and noninvasively reduce intratumoral perfusion in humans. Selected patients with glioblastoma or metastasis underwent tES, while perfusion was assessed using magnetic resonance imaging. Multichannel tES was applied according to personalized biophysical modeling, to maximize the induced electrical field over the solid tumor mass. All patients completed the study and tolerated the procedure without adverse effects, with tES selectively reducing the perfusion of the solid tumor. Results potentially open the door to noninvasive therapeutic interventions in brain tumors based on stand-alone tES or its combination with other available therapies.

Successful achievement after heterotopic transplantations of long-term stored ovarian tissue in Hodgkin's lymphoma survivor

In this case report, we describe the outcomes of two heterotopic transplantations of cryopreserved ovarian tissue performed in a patient with HL, after 11 and 15 years of storage. At the age of 30, the patient underwent laparoscopy to collect ovarian tissue for cryopreservation before chemotherapy and radiotherapy. Eleven years later she experienced premature ovarian failure (POF). As the patient was only interested in endocrine function recovery, two heterotopic ovarian tissue transplantations were performed in the abdominal wall above the rectus muscle respectively 11 and 15 years after cryopreservation. Before transplantation, ovarian samples were analyzed to assess neoplastic contamination and tissue quality. The analysis on thawed ovarian tissue did not reveal micrometastasis and it showed well-preserved follicles and stroma. After both ovarian tissue grafting, menopausal symptoms ceased. The patient had periods approximately every 30-days and hormonal levels were within the premenopausal range. The endocrine function lasted 3-years after the first heterotopic transplantation and is still ongoing after second transplantation. Cryopreservation of ovarian tissue should be proposed to HL patients, as the incidence of POF as a long-term complication is not negligible. In these patients heterotopic transplantation is a useful tool to eliminate menopausal symptoms, preventing osteoporosis and reducing cardiovascular risks.

CD200R deletion promotes a neutrophil niche for Francisella tularensis and increases infectious burden and mortality

Pulmonary immune control is crucial for protection against pathogens. Here we identify a pathway that promotes host responses during pulmonary bacterial infection; the expression of CD200 receptor (CD200R), which is known to dampen pulmonary immune responses, promotes effective clearance of the lethal intracellular bacterium Francisella tularensis. We show that depletion of CD200R in mice increases in vitro and in vivo infectious burden. In vivo, CD200R deficiency leads to enhanced bacterial burden in neutrophils, suggesting CD200R normally limits the neutrophil niche for infection. Indeed, depletion of this neutrophil niche in CD200R^−/− mice restores F. tularensis infection to levels seen in wild-type mice. Mechanistically, CD200R-deficient neutrophils display significantly reduced reactive oxygen species production (ROS), suggesting that CD200R-mediated ROS production in neutrophils is necessary for limiting F. tularensis colonisation and proliferation. Overall, our data show that CD200R promotes the antimicrobial properties of neutrophils and may represent a novel antibacterial therapeutic target.

The authors show that the CD200 receptor (CD200R) promotes effective clearance of pulmonary Francisella tularensis infection in knock out mice. This result is unexpected as CD200R is known to dampen pulmonary immune responses, and these data suggest that the beneficial effect against F. tularensis is due to depletion of a neutrophil niche for the bacterium.

Bilingual and Monolingual First Language Acquisition Experience Differentially Shapes Children's Property Term Learning: Evidence from Behavioral and Neurophysiological Measures

Studies of novel noun learning show bilingual children rely less on the Mutual Exclusivity Constraint (MEC) for word learning than monolinguals. Shifting the focus to learning novel property terms (adjectives), the present study compared 3.5- and five-year-old bilingual and monolingual preschoolers' adherence to the MEC. We found no bilingual-monolingual differences on a behavioral forced-choice task for the 3.5-year-olds, but five-year-old monolinguals adhered more to the MEC than bilinguals did. Older bilinguals adhered less to the MEC than younger ones, while there was no difference in MEC adherence between the younger and older monolinguals. In the 5-year-olds, we additionally acquired neurophysiological data using functional near-infrared spectroscopy (fNIRS) to allow for a first explorative look at potential neuronal underpinnings. The data show that, compared to bilinguals, monolinguals reveal higher activation over three brain regions (right frontal, left temporo-parietal, and left prefrontal) that may be involved in exploiting the MEC, building on conflict detection, inhibition, solution of a disjunction, and working memory processes. Taken together, our behavioral and neurophysiological findings reveal different paths towards novel property term learning depending on children's language acquisition context.